RESUMO
BACKGROUND: Uterine rupture is associated with clinically significant uterine bleeding, fetal distress, expulsion or protrusion of the fetus, placenta or both into the abdominal cavity requiring prompt cesarean delivery and uterine repair or hysterectomy. Previous cesarean section is the most common risk factor. The most consistent early indicator of it is the onset of prolonged and profound fetal bradycardia. OBJECTIVE: In this study, we present six cases of uterine rupture highlighting risk factors, and challenges in diagnosis and management, along with a review of the literature. METHOD: A retrospective case series identified eight cases during the five-year study period. All cases from January 1, 2018 to December 31, 2022 were reviewed. Cases with multiple previous cesarean sections were excluded. RESULT: Six cases meeting the study criteria were included in our case series. Uterine rupture was a rare occurrence with a prevalence of nine in 31,315 births representing 0.03% of deliveries. No maternal mortality or need for hysterectomy occurred in our study. Fifty percent of uterine ruptures were associated with stillbirths. The most common risk factor was a previous cesarean section in 83.3%. The most common presenting sign was non-reassuring fetal status patterns in 66.6%. A single case had a silent rupture. CONCLUSION: Signs and symptoms of uterine rupture are nonspecific making diagnosis challenging. Delay in definitive management causes significant fetal morbidity and mortality. For best outcomes, vaginal birth after a previous cesarean section needs close monitoring in appropriately prepared units with the ability to perform immediate cesarean delivery and provide advanced neonatal support.
RESUMO
BACKGROUND: Chorioamnionitis (CA) is a common pregnancy complication characterized by inflammation of the placental membranes and chorion. To our knowledge, there are limited studies evaluating the awareness of CA and its complications among women in Jeddah, Saudi Arabia. This study aimed to determine the awareness of married women in Jeddah toward CA and its complications. MATERIALS AND METHODS: This cross-sectional study was conducted between March 2021 and August 2021. It involved 406 women who were or have been married in Jeddah, Saudi Arabia. Data were obtained via an online survey and analyzed using IBM SPSS Statistics version 24 (IBM Corp., Armonk, NY). Different statistical tests were used for data analysis, including percentages, mean, frequency, and chi-square. Content validity and reliability were checked. Based on a woman's knowledge score, the score was classified into three levels: good knowledge level (score: 9-12), fair knowledge level (score: 5-8), and poor knowledge level (score: 0-4). RESULTS: Of the total number of women who participated in the study, most of them had a poor knowledge score about CA complications (49.95%), and only 8.1% had good knowledge. Among the women, 25% had previously heard about CA, while only 2.5% were diagnosed with CA, and 50% of these women delivered by cesarean section. Analysis showed a significant relationship between women who had CA and their birth method (p = 0.000). However, there was a nonsignificant difference between the females' knowledge and their age (p = 0.297), or their level of education (p = 0.099). CONCLUSION: The study concluded that there was a poor level of knowledge regarding CA and its complications among women who experienced pregnancy.